Coping with COVID-19, Part 2: Monitoring, Reducing Risk, and Problem Solving

By Michael Hattori

Michael continues to discuss tips and resources for the seven self-care behaviors that provide a foundation for managing your diabetes during challenging times

In the first part of this series, I introduced the AADE7, a set of self-care behaviors that can provide you with a rock-solid grounding for your diabetes management during the uncertainty and stress of the pandemic. We talked about strategies for coping, eating, taking medication, and exercising.

All of the behaviors we’ve discussed so far can (and will) change your blood sugar levels. So that’s where monitoring comes in.

Monitoring

COVID-19 has affected everyone’s daily lives hugely. Normal routines changed, loss of income, kids, spouses, and young adults all home all day … this can lead to high stress, and you can bet it’s going to affect your blood sugar – so checking and keeping track of your blood sugar is more important now than ever.

If you’ve read any of my previous articles, particularly Imagine 288 Fingersticks a Day: The Power of CGM, you will know that I am a huge fan of CGM, or continuous glucose monitoring. It is revolutionizing the management of diabetes. Sadly, not everyone has access to a CGM, but that is changing. If you’ve never discussed CGM with your doctor, now is a great time to take that opportunity – CGM could change your life.

If you take a look at the AADE7 graphic, you’ll see that Monitoring forms a ring around Healthy Eating, Being Active, and Taking Medication. Any idea why? Monitoring creates information, which can change your behavior in ways you might never have imagined. Here’s an imaginary situation:

Say you wear a CGM for two weeks. You notice that for several days after dinner your blood sugar goes way over 200. But then all of a sudden, over the next few days, it levels out, not going over 180. What happened? You kept a log (Monitoring), and sure enough, you started walking for 30 minutes after dinner (Being Active, Reducing Risk). You were so excited that the next day you walked for an hour! But that resulted in a very scary episode of low blood sugar. From this you learn that you should not only decrease the length of your walk, but also take glucose tablets with you (Problem Solving, Reducing Risk). Or perhaps you need to decrease the amount of insulin you take before your meal (Taking Medication) or increase your carb intake, if you are planning a long walk after a meal (Healthy Eating, Problem Solving). You also notice that your mood is so much better after you walk, and you are happier, which motivates you to keep walking (Healthy Coping).

Can you see how the simple act of checking your blood sugar results in a domino effect of positive changes? Knowledge is Power. And you just covered ALL of the AADE7.

Monitoring isn’t limited to just checking your blood sugar. It’s also about checking blood pressure, heart rate, carb and calorie intake, weight, activity, mood, sleep, medication, and foot and skin health, among other types of self-care.

When I get up in the morning, I check my blood pressure and heart rate, and put the numbers into my One Drop app. I’m in type 2 diabetes remission, but I still check my blood sugar at least twice a week and get an A1C test every three months. Knowing your numbers is a great way to get motivated and stay motivated. It can help you set goals, stay accountable, and feel better about yourself. If you haven’t been monitoring your numbers regularly, I think you’ll be surprised at how many good things come of it.

Reducing Risk

Having diabetes increases your risk of being hospitalized if you contract COVID-19, particularly if you also have other long-term health complications. So, what can you do to Reduce Risk? What is reducing risk?

Reducing risk is using the information you’ve gathered about your health (Monitoring) to make informed decisions (Problem Solving) that result in avoiding or minimizing complications or adverse outcomes, such as hypoglycemia, hyperglycemia, and many other long-term complications.

Reducing risk also ties in closely with Healthy Eating, Being Active, Taking Medication, since all three of these self-care behaviors can result in better outcomes in the short and the long term.

So what are some things you can do to reduce risk? Here’s a short list:

• Participate in diabetes self-care management education and support. Take the opportunity to talk with a diabetes care and education specialist. Share your list of concerns, especially in relation to COVID.

• Be engaged in your health. Monitor, seek advice, share concerns – the more engaged you are, the more likely you are to feel better and become an expert at managing your diabetes.

• Get good, adequate sleep. Poor sleep or not enough sleep can contribute to higher blood sugars, higher A1C, weight gain, heart disease, high blood pressure, and obesity. There are measures you can take to check your sleep quality. If you have concerns about your sleep, make sure you talk to your healthcare team. Learn more about sleep here.

• Make and keep appointments. With COVID-19, this is more of a challenge, but many offices are offering either phone or video appointments.

Problem Solving

The COVID crisis has forced people to become expert problem solvers in many ways. For a person with diabetes, it really is about being engaged and finding ways to cope. So, you see, we’ve come full circle back to Healthy Coping.

For me, it’s about finding a calm center. I start my day out with something as relaxing as possible: for me, that’s a cup of coffee and classical music. It relaxes me and allows me to center on my main concerns for the day. I live alone, so I have no distractions. If you have a family, you might have to find other ways to carve out a little piece of calm in the center of the storm, like taking a short walk before everyone gets up. Set your priorities, and deal with them one by one.

Succeeding at solving problems is important because it gives you a sense of confidence, an ability to deal with future problems. It also creates a sense of well-being and generates positive conversations. And they don’t have to be huge things – remember how the simple decision to walk after dinner resulted in much improved blood sugars?

Be systematic. What is the problem (identify)? What can I do about it (solution)? How did that work and what could be improved (reflect)? Writing the problem down, then brainstorming works really well for me. If I’m stuck, I ask someone else for advice. Remember to ask for help.

This is a great time to seek and take advantage of the many diverse support groups on the internet and social media. Sometimes family is just too close, and having a less intimate connection with another person with diabetes can make all the difference. And you can bet that there are scores of people out there with exactly the same concerns and problems you have. So reach out! If you’re on Facebook, just type “diabetes” into the search field and you’ll be amazed at how many groups there are. Just remember that not all the information you may find is correct or valid. Use your judgment, and ask an expert if you’re unsure, especially if it has to do with medications.

Whew! If you’ve stuck with me to the end (and I hope you have), you should be well-armed with the building blocks you need to set your own AADE7 foundation, and build from there. Make it your castle. And don’t forget to get others to help you build it.

Be safe! Be well!

Read Part 1 of Michael's Coping with COVID-19.

About Michael

Michael Hattori has been a Registered Nurse for 23 years (including 19 years in the Operating Room), and is currently training to become a Certified Diabetes Care and Education Specialist after being diagnosed with type 2 diabetes in 2019. He has since achieved remission, but still closely follows the AADE 7 Self Care Behaviors to keep on track. He is a huge fan and major advocate of continuous glucose monitoring (CGM) and attributes his remission in large part to CGM. 

Michael is an avid chef, photographer, musician, and fiber artist in his free time.